Regular exercise is important if you have symptoms of osteoarthritis, a common degenerative condition of the joints. But if you work out too hard or don’t take precautions, you may end up with even more pain than before. Read on for 10 expert tips on how to exercise for arthritis relief the right way...

When osteoarthritis pain flares, the last thing you want to do is exercise.

But make an effort to exercise for arthritis anyway, because a lack of physical activity leads to a vicious cycle, says Ronald P. Reichman, M.D., a specialist in rheumatology and internal medicine at Cedars-Sinai Medical Center in Los Angeles.

For example, you may gain weight, which puts more stress on joints and increases osteoarthritis pain. Exercising reverses this.

It can also fight arthritis-related joint stiffness and discomfort.

“Exercise strengthens the muscles around joints and keeps them functioning and in proper alignment,” Dr. Reichman says.

Like car tires, joints wear out faster when they’re out of alignment. So strengthening muscles – around the knee, for example – prevents further deterioration by keeping the joint moving correctly.

Exercise for arthritis also maintains the joints’ range of motion – the extent to which they can be moved, rotated or extended. That makes it easier for them to handle everyday movements, Dr. Reichman says.

Here are 10 expert tips on the best ways to stay active, fight arthritis and keep functioning at your best.

1. Start slowly.If you’re a beginner or returning after an exercise hiatus, don’t do too much too soon. That may cause pain and inflammation around joints, Dr. Reichman says.

“Gradually add only a few minutes to each workout and slowly increase range of motion if you’ve lost flexibility,” he recommends.

Start with just 10 minutes, even if you have to leave a class before it’s over. Then assess its impact on your body.

“If you’re not in pain two hours later, add five minutes to your exercise routine the next day,” Dr. Reichman says.

Ideally, you want to work up to 30 minutes of exercise for arthritis, says Robin K. Dore, M.D., a rheumatologist at St. Joseph’s Hospital in Tustin, Calif.

3. Do low-impact workouts.To reduce the risk of osteoarthritis pain, keep stresses on lower-body joints – such as knees and hips – to a minimum, Dr. Reichman says.

“Light” exercise, such as walking, swimming or using an elliptical trainer, is best for people at risk for osteoarthritis symptoms, according to a 2010 University of California, San Francisco study.

Magnetic resonance imaging (MRI) showed that light exercisers had healthier knee cartilage compared with runners or those who did strength-training often.

And frequent knee-bending activities – climbing up at least 10 flights of stairs a day, lifting objects of more than 25 pounds, squatting or kneeling for at least 30 minutes a day – was associated with more cartilage abnormalities.

Another good way to exercise for arthritis is stationary cycling, which reduces the risk of injury, unless you’re adept at cycling outdoors on a regular bike, says Dr. Reichman.

Adjust your bicycle seat to a level that allows your knee to remain slightly bent on the down stroke.

Or a recumbent bike may be better if you have back pain, because your lower back is supported and there’s no strain on your upper back and neck, Dr. Reichman says.

4. Warm up thoroughly.A gentle warmup increases blood flow to muscles, loosens them and reduces risk of an injury that could lead to osteoarthritis pain, Dr. Reichman says.

The Arthritis Foundation recommends a 3-5-minute warm-up of walking or marching in place. Start gradually and speed up the pace after a few minutes.

“Tai chi is a nice, slow way to warm up the body without putting a lot of strain on joints,” Dr. Borenstein says.

Tai chi movements mimic those we do naturally in real-life situations, such as bending and reaching forward and sideways.

People with symptoms of osteoarthritis or rheumatoid arthritis who practiced tai chi twice a week for eight weeks reported less pain, stiffness and fatigue and better physical function, according to a 2010 study by the University of North Carolina at Chapel Hill School of Medicine.

They also reported lower blood pressure and better sleep.

Tai chi classes may be offered at local schools, hospitals, martial-arts studios, fitness centers or the YMCA. Or purchase an instructional DVD from the Arthritis Foundation.

6. Get in the water.Water workouts are one of the best low-impact exercises for arthritis, because water reduces the effect of gravity and stress on the knee, Dr. Reichman says.

It also offers both cardio and resistance training, because your muscles are pushing against water.

Because water supports and stabilizes your upper body, “water exercise is especially helpful for women with osteoarthritis pain in the back or neck,” Dr. Borenstein says.

To alleviate pain while swimming, use a snorkel and mask so you don’t lift your head to breathe. “They enable you to swim without extending the spine, which can cause pain,” he says.

Also, work out in a heated pool if you can. Most people feel less osteoarthritis pain in warmer water, says Dr. Borenstein. “Cool water can heighten sensitivity and cause those with OA to become more aware of aches and pains,” he says.

For example, the mall may be OK for a stroll, “but walking on cement combined with the wrong shoe can cause osteoarthritis pain to flare,” he says.

That’s because hard cement floors create more pressure against your foot and send it throughout your extremities, says Dr. Borenstein. That’s why a softer surface, such as a school running track or cushioned treadmill, is better for people with osteoarthrtitis, he says.

When choosing athletic footwear, make sure it offers enough support and cushioning.

“You should feel the bottom of the shoe, not the floor,” Dr. Borenstein says.

If osteoarthritis affects your toes, you may need a shoe with a wider toe box, he says.

Hold each stretched position for a count of 10; relax for a count of 5, then do it again.

Gentle stretching exercises should be done every day to fight arthritis, says Dr. Schmalzried. “Work up to 15 minutes a day.”
For more information, visit our Arthritis Health Center.

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